Abstract

MOAE0105LB - Oral Abstract

Utilizing available HIV/AIDS infrastructure as a gateway to effective case finding and management of non-communicable diseases (NCDS) including hypertension, diabetes and mental disorders at Mildmay, Uganda

Background: Uganda, like other countries with a high burden of HIV infection
is facing burgeoning epidemics of non communicable diseases. The population of patients with HIV infection
achieving viral suppression on combination ART is growing, aging, and
experiencing a widening spectrum of non-AIDS diseases. HIV
and NCD care both require ongoing attendance at appointments, adherence to
tests and medications, healthy living and self-management. Mildmay Uganda,
fully integrated NCD screening and management in 2013 to identify risk factors
for cardiovascular disease among, people living with HIV enrolled in care and
to provide medical and behavioral interventions.Description: A review of physical
and electronic longitudinal data was conducted to improve clarity on diagnosis
by the clinicians and tracking of clients with NCD in the Mildmay Uganda (MUg) system.
Data collection tools were developed to capture NCD specific data from the
clients including basic demographics, associated hereditary factors, alcohol or
nicotine use, results of clinical assessments, laboratory assessments, treatment
and referral plans. Standard operating procedures have been developed for
diagnosis and management of NCDs at MUg. Clients who miss their routine
appointments are followed up through telephone calls or home visits as
necessary. Medical records/ files for
HIV positive clients with hypertension or other NCDs have been tagged and clinicians
sensitized on management of HIV- NCD co-morbidity. To maximize clinic outcomes
including support for client education, since 69% of those with HIV- NCD
co-morbidity are also elderly Tuesday has been designated as NCD/ elderly clinic
day.Lessons learned: The existing HIV care and treatment infrastructure
provides a viable platform for screening and managing NCD especially for a population aging with HIV. The diagnosis, tracking and
management of NCDs, particularly Hypertension, diabetes, cardiovascular disease
and mental health as part of routine HIV care have improved markedly. Overall,
out of 10,285 active clients in care at MUg Main site, 1058 have been
identified with Hypertension; 12.7% of whom have mental disorders, including
depression, mania and epilepsy while 8% have diabetes, 34% are aged
over 60 years while 69 % are females and 73% are on ART.Conclusions/Next steps: Scaling up the implementation to all 16 Mildmay supported districts in central Uganda.